Predictors of Quality of Life Six Years after Curative Colorectal Cancer Surgery: Results of the Prospective Multicenter Study
Gintare Valeikaite-Tauginiene,
Agne Kraujelyte,
Eligijus Poskus,
Valdemaras Jotautas,
Zilvinas Saladzinskas,
Algimantas Tamelis,
Paulius Lizdenis,
Audrius Dulskas,
Narimantas Evaldas Samalavicius,
Kęstutis Strupas,
Tomas Poškus
Affiliations
Gintare Valeikaite-Tauginiene
Clinic of Gastroenterology, Nephrourology, and Surgery, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Santariskiu Str. 2, 08661 Vilnius, Lithuania
Agne Kraujelyte
Faculty of Medicine, Vilnius University, Ciurlionio Str. 21, 03101 Vilnius, Lithuania
Eligijus Poskus
Clinic of Gastroenterology, Nephrourology, and Surgery, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Santariskiu Str. 2, 08661 Vilnius, Lithuania
Valdemaras Jotautas
Clinic of Gastroenterology, Nephrourology, and Surgery, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Santariskiu Str. 2, 08661 Vilnius, Lithuania
Zilvinas Saladzinskas
Clinic of Surgery, Lithuanian University of Health Sciences, Eiveniu Str. 2, 50009 Kaunas, Lithuania
Algimantas Tamelis
Clinic of Surgery, Lithuanian University of Health Sciences, Eiveniu Str. 2, 50009 Kaunas, Lithuania
Paulius Lizdenis
Clinic of Surgery, Lithuanian University of Health Sciences, Eiveniu Str. 2, 50009 Kaunas, Lithuania
Audrius Dulskas
Faculty of Medicine, Vilnius University, Ciurlionio Str. 21, 03101 Vilnius, Lithuania
Narimantas Evaldas Samalavicius
Clinic of Internal, Family Medicine and Oncology, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Santariskiu Str. 2, 08661 Vilnius, Lithuania
Kęstutis Strupas
Clinic of Gastroenterology, Nephrourology, and Surgery, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Santariskiu Str. 2, 08661 Vilnius, Lithuania
Tomas Poškus
Clinic of Gastroenterology, Nephrourology, and Surgery, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Santariskiu Str. 2, 08661 Vilnius, Lithuania
Background and objectives: Improving early diagnosis and advances in colorectal cancer (CRC) treatment leads to longer survival of these patients. The purpose of this study was to identify the main surgical factors affecting long-term Quality of life (QoL) among colorectal cancer patients after surgery. Materials and Methods: QoL was prospectively evaluated in patients undergoing elective colorectal cancer resection operations in three CRC surgery centers of Lithuania using EORTC generic (QLQC-30) and disease-specific (QLQ-CR29) questionnaires at the time of preoperative admission and 1, 24, and 72 months after surgery. QoL was evaluated among different patient groups, diagnostic and treatment modalities, disease, and postoperative complications. Non-parametric tests and multivariate logistic regression models were used for statistical analysis. Results: Eighty-eight consecutive CRC patients from three institutions were included in the study over a three-month inclusion period, 42 (47.73%) women and 46 (52.27%) men, mean age 64.2 ± 11.5 years. Most tumors were localized in the sigmoid colon and rectum. The largest number of patients had stage III cancer. Twenty-nine patients died—a 6-year survival rate was 67%. 50 of 59 live patients (84.8%) responded to the questionnaire 6 years after their operation. Evaluating changes in quality of life 72 months after surgery with assessments before surgery, both questionnaire responses revealed good long-term CRC surgical treatment results: improved general and functional scale estimates and decreased symptom scale ratings. The multivariate analysis found that age, stoma formation, and rectal cancer were independent risk factors for having worse QoL six years after surgical intervention. Conclusions: Six years after surgery, QoL returns to preoperative levels. Age, stoma formation, adjuvant treatment, and rectal cancer reduce long-term QoL.
